摘要
目的对老年股骨颈骨折患者行人工双极股骨头置换与全髋关节置换的临床效果进行对比研究。方法将收治的100例股骨颈骨折行髋关节置换患者按照手术方式分为人工双极股骨头置换组与全髋关节置换组,每组50例,分别从手术时间、术中出血量、平均住院日、平均住院费用,以及术后3 d疼痛视觉模拟量表(VAS评分)、肿胀率及术后3周、1年的髋关节功能评分标准(Harris评分)等方面对两组进行对比分析。结果人工双极股骨头组的手术时间、术中出血量及总输血量、术后3 d VAS评分及术后3 d肿胀率、平均住院费用均明显较全髋关节置换组患者降低(P<0.05);两者之间平均住院时间差异无统计学意义(P>0.05);全髋关节置换组患者术后3周及术后1年Harris评分均明显增高,差异均有统计学意义(P<0.05)。结论老年股骨颈骨折患者手术应当综合考虑到患者的身体状况、预期寿命及经济条件;患者身体素质相对较好,预期寿命较长及经济条件较好,能够耐受手术创伤,首先选择全髋关节置换;身体较差,预期寿命较短,无法耐受手术创伤,则一般选择人工双极股骨头置换。
Objective To explore and analyze the artificial bipolar femoral head replacement and total hip replacement in elderly patients with femoral neck fracture for conduct the comparison of clinical effects.Methods One hundred cases of femoral neck fracture undergoing hip replacement in the surgery department of this hospital were divided into the artificial bipolar femoral head replacement group and total hip replacement group according to the operation method,50 cases in each group.The comparative analysis of the two groups was conducted from the aspects of the operation time,intraoperative blood loss volume,average hospitalization days,average hospitalization expenses,pain visual analogue scale(VAS score)and swelling rate on postoperative day 3,and hip function score stand-ard(Harris score)in postoperative week 3,year 1.Results The operation time,intraoperative blood loss volume,total blood transfusion volume,VAS score and swelling rate on postoperative day 3,and average hospitalization cost in the artificial bipolar femoral head replacement group were significantly reduced compared with those in the total hip replacement group(P<0.05).There was no statistically significant difference in the average hospitalization time between the two groups(P>0.05).The Harris scores in postoperative week 3 and year 1 in the total hip arthroplasty group were significantly increased,and the difference was statistically significant(P<0.05).Conclusion The operation in the elderly patients with femoral neck fracture should comprehensively consider the physical condition of the patients,life expectancy and economic conditions;for the patients with relatively better physical quality,longer life expectancy,better economic condition,and tolerance to operation trauma,the total hip replacement is the first selection;while aiming at the patients with poor health,short life expectancy and intolerance to surgical trauma,the artificial bipolar femoral head replacement is generally selected.
作者
张伟
ZHANG Wei(Department of Surgery,Mian County Red Cross Hospital,Hanzhong,Shaanxi 724200,China)
出处
《检验医学与临床》
CAS
2020年第11期1564-1567,共4页
Laboratory Medicine and Clinic
关键词
股骨颈骨折
全髋关节置换
人工双极股骨头置换
femoral neck fracture
total hip arthroplasty
bipolar femoral head replacement
